INCREASING IMMUNIZATION - A MEDICAID MANAGED CARE MODEL

Objective. To evaluate the impact of an immunization outreach program on immunization rates. Setting. A Pennsylvania independent practice as sociation model managed care organization (100% Medicaid). Design. Ret rospective cohort study (N = 2511) of children 30 to 35 months of age from two age cohorts that compared immunization rates for Advisory Com mittee on Immunization Practices schedules for diphtheria-tetanus-pert ussis, oral polio vaccine, measles-mumps-rubella, and Haemophilus infl uenza type b, An evaluation of the outreach component of the program c ompared treatment and nontreatment subgroups of one age cohort (N = 10 02). Intervention. The immunization program targeted approximately 19 000 members from birth to 6 years of age. The program components inclu ded computerized tracking and reminders, member and provider education , provider incentives, member incentives, and home visiting outreach. Results. Data indicate that the treatment group has higher completed i mmunization rates at 35 months of age than does the control group. Fur thermore, data show that members with home visits have significantly h igher completed immunization rates than do other members. The correspo nding comparisons for age-appropriate immunizations by 24 months indic ate a nonsignificant trend of increased rates. Conclusion. The data pr ovide evidence supporting a correlation between comprehensive strategi es (computerized tracking, member and provider education and incentive s, and home visiting) and increased immunization rates. Those individu als who received home visits were more likely to complete an immunizat ion series by 35 months of age than those who did not. However, within the Mercy Health Plan program, age-appropriate immunizations are not significantly affected by home-visiting outreach.